Wiki Help with ADHD diagnosis?

[Brandy0618]

We have always used the diagnosis code 314.01 in reference to ADHD follow up. The child has been diagnosed and is followed every 6 mo while on medication. Until yesterday (after reading my pediatric newsletter on supercoder) it states that we are to be using V58.69 for follow ups to ADHD. It states that we are to only use 314.01 for the initial diagnosis, and that all other follow ups to those meds we are to be using V58.69? However, there is conflicting advice all over the internet from coders on this issue. Can any one shed some light on this for me? I would appreciate any help. Thank you so much. Brandy CPC

 

[Cynthia Hughes]

I have not read the article but disagree as chronic conditions like ADHD may be reported for as long as they exist and are being managed. The V58.69 informs only that a drug is being used long-term. Even if the physician were only monitoring the effectiveness of the drug, code V58.83 would likely be the listed before V58.69 as AHA Coding Clinic has stated that this code applies to both blood and other tests to determine the effectiveness of drug therapy (eg, Vanderbilt testing would be included). However, the physician is much more likely monitoring the status of the ADHD, assessing comorbidity (eg, depression, drug abuse), and side effects of treatment. This is not unlike monitoring a patient with high blood pressure who may be stable on current medications for long periods of time.

Just my thoughts.
Cindy

 

[mitchellde]

I have not read the article but disagree as chronic conditions like ADHD may be reported for as long as they exist and are being managed. The V58.69 informs only that a drug is being used long-term. Even if the physician were only monitoring the effectiveness of the drug, code V58.83 would likely be the listed before V58.69 as AHA Coding Clinic has stated that this code applies to both blood and other tests to determine the effectiveness of drug therapy (eg, Vanderbilt testing would be included). However, the physician is much more likely monitoring the status of the ADHD, assessing comorbidity (eg, depression, drug abuse), and side effects of treatment. This is not unlike monitoring a patient with high blood pressure who may be stable on current medications for long periods of time.

Just my thoughts.
Cindy

If the person reason for the visit is to monitor and adjust medication the I agree the V58.83 should've first listed followed by the V58.69, if the status of the condition is also addressed then I agree the code for yh condition should be listed third. It really depends on how it is documented as the reason for the encounter.